14322 (RPL)�,; •
0�6
'V 4
Building
Address Skas--2-ao Ave. Velasco
Owner 0 fi D Const -ruction
Mailing 51-960 Ave. Ferrera
Address
City
La Quiata r CA
Contractor
Saga
Address
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Zip Tel. '
92253 771-1561
No. 14322
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description PGCE -1 and Sp
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) valuation
'or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
•pmploy any person in any'manner.so as to become subject to the -Workers' Compensation
- >ILaws of�alifornia��Y r' ! j' ; • r`
Dater r rS/ Owner
TICE-TO APPLICANT: ff, after making this Certificate of Exemption you should become
subject to the -Workers' Conpensatlon provisions of the Labor Code; you must - forthwith
comply with such provisions or this permit shaft be deemed revoked. - .
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706. OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This•is a building permit when properly filled out; signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I'have read this application and state that the above information is correct:
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city .to enter. the above
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
ZONE:
BY:
Minimum Setback
' City
Zip
Tel.:
Rear Setback from Rear Prop. Line
State Lic. B 681012
& Classif.
City 323
Lic. #
Sq. Ft.
Size
No. No. Dw.
Stories Units
' Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Date eP rm-.
Validated by:
V
City
Zip
State
Lic. #
' r
" LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions. Code, and my license is in full force and
effect. i q t
+
SIGNATURE" DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,6usiness and .Professions Code: Any city. or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance+ also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section -7000) of
• Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 'by 'any applicant for a permit
subjects the applicant to a civil penaltydf not more than five hundred dollars ($500). -
❑ I, as owner of the property, or my employees with wages as.their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not -apply to an owner•of property who
builds or Improves thereon and who does such, work himself or through, his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
N
of proving.that he did not build or improve for e purpose of sale.) ..
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and.Professions Code: The- Contractor's License Law
. does not apply to an, owner of property who builds or improves thereon, and. who contracts for
such projects with a contractors) pcensed pursuant to the Contractor's License Law.) -
O I am exempt under Sec B. & P.C. for this reason
Estimated Valuation
t� np lr; 1��t
.$9 000 • 00
-
PERMIT'
AMOUNT
. -
Plan Chk. Dep.
-
,� •, '
Plan Chk. Bal.
V �.
01 R
IV
CiOr1St.
• J
.+w ..
Mech.
Electrical - ' '
'_V • 6a
'
Plumbing .47
, -
w V 0
S. M.1.
Grading
Driveway Enc.
Date Owner
"Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have•a certificate of consent to self -insure, or'a certificate -of-.
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. O Certified copy is hereby furnished.
" '�-•
-
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) valuation
'or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
•pmploy any person in any'manner.so as to become subject to the -Workers' Compensation
- >ILaws of�alifornia��Y r' ! j' ; • r`
Dater r rS/ Owner
TICE-TO APPLICANT: ff, after making this Certificate of Exemption you should become
subject to the -Workers' Conpensatlon provisions of the Labor Code; you must - forthwith
comply with such provisions or this permit shaft be deemed revoked. - .
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706. OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This•is a building permit when properly filled out; signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I'have read this application and state that the above information is correct:
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city .to enter. the above
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
ZONE:
BY:
Minimum Setback
Distances:',
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Une
Side Setback from' Property.Line
FINAL DATE
I . ' ECT 1
Issued by:
Date eP rm-.
Validated by:
V
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIWI fEES `
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
BONDING
MOBILEHOME SVC.
BAR SINK
POR SQ FT ®
SEWER OR SEPTIC TANK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CARP. SQ. FT.
HEATING (FINAL)
OTHER APP./EQUIP.
WALL SQ. FT.
DRINKING FOUNTAIN
SQ FT ® _
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
FIREPLACE
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® I Va c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
AS (ROUGH)—
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL) -5110106'41
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ Plus—x$—=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
_
GARDEN WALL FINAL
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